Overwhelmed with patients in need of care after sustaining significant damage and loss from the most powerful Atlantic storm ever recorded, the Princess Alexandra Hospital in Anguilla lacked the necessary resources to provide aid to some of these patients. Lenard Christmas was among those needing treatment and monitoring due to a non-functioning dialysis shunt and a serious infection of his dialysis line, which was preventing him from receiving regular dialysis care. Unable to provide the necessary treatment for him, the Princess Alexandra Hospital requested the assistance of the HSA.

Arrangements were made by Cabinet Secretary Samuel Rose for Mr Christmas, along with his wife, Juliana, to be transported by Cayman Airways to the Cayman Islands where he was treated at the Cayman Islands Hospital.

To facilitate the patient’s ongoing dialysis treatment HSA Consultant Vascular and General Surgeon Dr Adam Sowinski replaced the infected dialysis line. However, the need for further surgical intervention was identified after the patient showed signs of acute superior vena cava (SVC) syndrome, a condition caused by acutely blocked drainage of blood from the upper part of the body, the neck and head into the heart. It is considered a surgical emergency as symptoms include swelling of both upper limbs and neck, breathing difficulties and brain oedema.

Clinical intervention to resolve this problem required the involvement of HSA’s Interventional Radiologist Dr Vladimir Sloboda, who worked with Dr Sowinski to perform an interventional procedure known as endovascular stenting of the superior vena cava.

“In comparison to open surgery, this minimally invasive treatment has significantly lower risks of complications, does not leave behind scars, results in lower blood loss, has significantly quicker recovery times, offers the option to use local or regional anaesthesia instead of general anaesthesia and involves less discomfort and pain,” said Dr Sloboda.

“Had this lifesaving procedure not been performed, Mr Christmas might have then developed breathing difficulties due to swelling of the airways and brain oedema. However, after treatment the symptoms of his condition disappeared and he was able to return home to his family with a new, functional dialysis line and a new dialysis shunt,” he stated.

This procedure has only been performed twice in the Cayman Islands and on both occasions by Dr Sloboda. “The first outcome was just as successful as the second,” said Dr Sloboda.

In addition to the medical assistance the Christmases received from the HSA and their transport facilitated by the Cabinet Secretary, Foster’s Food Fair donated a $250 gift card and Comfort Suites and locals, Deb and Will Ryan, provided accommodations free of cost for Mrs Christmas. A member of the HSA medical relief team and registered nurse, Riley Ondoy, also volunteered to accompany the fully recovered Mr Christmas on a commercial flight back home.

Mrs Christmas said she was grateful and amazed by the quality of care and kindness they received from the moment they arrived on island to their departure. “Before I left Anguilla I was so surprised when I spoke to the Chairman of the Princess Alexandra Hospital who told me that everything was taken care of and that I would have a place to stay, transportation to and from the hospital and immediate medical attention for my husband. I am very grateful for all the assistance we received, from the generous donations from all the organisations involved to the kindness of the Ryans who opened their home to me,” she stated.

“I was also impressed by the speed of the care my husband received and the genuine hospitality that was shown by the staff of the HSA who went above and beyond to make sure I was well taken care of and felt safe. They worked very hard and I believe my husband received the best quality care,” she added.